Healthcare Provider Details

I. General information

NPI: 1700101219
Provider Name (Legal Business Name): MICHAEL S. CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 ALEXANDER RD STE 202
PRINCETON NJ
08540-6331
US

IV. Provider business mailing address

PO BOX 500409
SAIPAN MP
96950-0409
US

V. Phone/Fax

Practice location:
  • Phone: 609-419-0400
  • Fax: 609-419-9200
Mailing address:
  • Phone: 670-236-8210
  • Fax: 670-233-8756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number25MA10105900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number0718
License Number StateMP
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0718
License Number StateMP
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA10105900
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number25MA10105900
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0718
License Number StateMP

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: